Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie最新文献_第6页

[Practice Guidelines for Central Venous Access 2020 - Time for German Guidelines]. [2020 年中心静脉通路实践指南--德国指南的时代]。

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-04-01 Epub Date: 2024-04-29 DOI: 10.1055/a-1690-5730

Wolf Armbruster, Rüdiger Eichholz, Thomas Notheisen

{"title":"[Practice Guidelines for Central Venous Access 2020 - Time for German Guidelines].","authors":"Wolf Armbruster, Rüdiger Eichholz, Thomas Notheisen","doi":"10.1055/a-1690-5730","DOIUrl":"10.1055/a-1690-5730","url":null,"abstract":"The American Society of Anesthesiologists released practice guidelines for central venous access in 2020, and the entire world literature was examined for evidence on how to perform the entire process with best practice and minimal risk and harm to the patient. These guidelines may serve as a gold standard for individual procedural steps, allowing practitioners and hospital departments to critically question the own standard and improve upon them.We interpreted the guidelines for individual procedural steps on how to improve success of catheterization, minimize risks or adverse effects, enhance the management of accidental arterial punctures, adhere to evidence-based practices, and generally reduce the trauma of puncturing. In our opinion, the most needed recommendation for central venous access is to utilize ultrasound guidance, a practice that many international societies have already incorporated into their published national guidelines.In our view, it is time to implement a national guideline for central venous access using ultrasound in Germany. Doing so may improve success rates in the first attempt, reduce procedural time, decrease the number of needle insertions per patient, and lower the rate of arterial punctures. This approach represents best practice from ethical, insurance, civil rights, and patient security perspectives, and is supported by relevant societies.","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 4","pages":"252-262"},"PeriodicalIF":0.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Extracorporeal Cardiopulmonary Resuscitation(ECPR) - the Future?] [体外心肺复苏（ECPR）--未来？］

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-04-01 Epub Date: 2024-04-29 DOI: 10.1055/a-2082-8761

Adrian Springer, Michael Stöck, Stephan Willems, Berthold Bein, Eike Tigges

{"title":"[Extracorporeal Cardiopulmonary Resuscitation(ECPR) - the Future?]","authors":"Adrian Springer, Michael Stöck, Stephan Willems, Berthold Bein, Eike Tigges","doi":"10.1055/a-2082-8761","DOIUrl":"10.1055/a-2082-8761","url":null,"abstract":"In recent years, invasive resuscitation methods utilizing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) have gained significant attention. Despite advances in traditional resuscitation measures, out-of-hospital cardiac arrest (OHCA) mortality remains high. In the context of extracorporeal cardiopulmonary resuscitation (ECPR), VA-ECMO therapy offers a promising approach by providing circulatory support during cardiac arrest, allowing time for diagnostic evaluation and targeted therapy. However, patient selection for ECPR remains a challenge, relying on various factors including initial rhythm, duration of no-flow and low-flow states, as well as presence of reversible causes.Recent studies such as the ARREST, Prague OHCA and INCEPTION trials have investigated the efficacy of ECPR in OHCA patients, yielding mixed results. While the ARREST trial demonstrated a survival benefit with ECPR, the Prague OHCA and INCEPTION trials showed varying outcomes, reflecting the complexity of patient selection and treatment strategies. Despite inherent risks and complications associated with ECPR, it may offer a potential survival advantage under optimal conditions.Future directions in ECPR involve the development of innovative treatment protocols such as the CARL therapy, which incorporates specialized ECMO systems and tailored perfusion solutions. Early studies indicate promising outcomes with CARL therapy, emphasizing the importance of a well-coordinated and structured approach to ECPR implementation.In summary, ECPR shows promise in improving survival rates for OHCA patients within a well-organized healthcare system. However, further research is needed to refine patient selection criteria and optimize treatment protocols, ultimately enhancing patient outcomes in cardiac arrest scenarios.","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 4","pages":"226-235"},"PeriodicalIF":0.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Cardiopulmonary Resuscitation 2024: Same, Same But Different]. [心肺复苏术 2024：相同、相同但不同]。

IF 0.3 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-04-01 Epub Date: 2024-04-29 DOI: 10.1055/a-2281-0530

Berthold Bein, Jens Scholz

引用次数: 0

[Resuscitation Update - What's New?] [复苏最新消息--有什么新消息？］

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-04-01 Epub Date: 2024-04-29 DOI: 10.1055/a-2082-8685

Jan-Thorsten Gräsner, Stephan Katzenschlager, Leonie Hannappel, Jan Wnent

{"title":"[Resuscitation Update - What's New?]","authors":"Jan-Thorsten Gräsner, Stephan Katzenschlager, Leonie Hannappel, Jan Wnent","doi":"10.1055/a-2082-8685","DOIUrl":"10.1055/a-2082-8685","url":null,"abstract":"Perfect, uninterrupted basic life support (BLS) is the key for successful cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA). Time plays an important role in the treatment of OHCA. This applies both to the time until the start of BLS and the reduction of all pauses during resuscitation, especially chest compressions. In 2022, the rate of bystander-CPR showed an absolute increase of 4% compared to previous years. The bystander-CPR rate is currently above 50%. Compared to OHCA in adults, cardiac arrest in children is rare in Germany. In the period from 2007 to 2021, the incidence was 3.08 per 100000 children. In addition, the etiology in children varies depending on the age group. While hypoxia is often the cause of circulatory arrest in younger children, trauma and drowning accidents are the main causes in school-age children. Different additional diagnostic and therapeutic strategies have been evaluated over the last years. Point-of-care ultrasound during resuscitation should only be performed by experienced users. Interrupting chest compressions and thus prolonging the no-flow phases must be avoided. Double sequential external defibrillation after the third shock can successfully terminate refractory ventricular fibrillation. While further studies are needed, emergency medical systems should train their teams to avoid complications. In refractory OHCA, extracorporeal CPR should be considered. In the case of in-hospital cannulation, immediate transport should be weighed against impaired chest compression quality. Therefore, transportation under CPR is only beneficial if there is an indication for further treatment.","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 4","pages":"214-225"},"PeriodicalIF":0.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Peripheral Regional Anesthesia Techniques - Standards in Flux?!] [外周区域麻醉技术--不断变化的标准？］

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1055/a-2065-7696

Thomas Wiesmann, Thorsten Steinfeldt, Ann-Kristin Schubert

{"title":"[Peripheral Regional Anesthesia Techniques - Standards in Flux?!]","authors":"Thomas Wiesmann, Thorsten Steinfeldt, Ann-Kristin Schubert","doi":"10.1055/a-2065-7696","DOIUrl":"10.1055/a-2065-7696","url":null,"abstract":"This review article provides an overview of current developments in peripheral regional anaesthesia (RA). The authors present a subjective compilation based on discussions at professional events and inquiries to the Working Group on Regional Anaesthesia of the German Society for Anaesthesiology and Intensive Care Medicine (DGAI). The article addresses several relevant topics, including the handling of antithrombotic medication in peripheral blockades with reference to European guidelines, the debate on the discharge timing after plexus anaesthesia, and the consideration of rebound pain as an independent pain entity following RA.Furthermore, the contentious discussion regarding the administration of peripheral nerve blockades under general anaesthesia is illuminated. The authors express no fundamental concerns in this regard but emphasize the importance of preoperative evaluation and individual patient needs. The question of mixing local anaesthetics is also addressed, with the authors critically questioning this tradition and recommending the use of individual, long-acting substances.Another focal point is the application of peripheral nerve blockades in emergency medicine, both in preclinical and emergency room settings. The authors highlight the necessity for high-quality studies and discuss the complex organizational issues associated with the preclinical application of RA techniques.","PeriodicalId":7789,"journal":{"name":"Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie","volume":"59 3","pages":"180-189"},"PeriodicalIF":0.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quiz intensiv – Stellen Sie die Diagnose! 强化测验 - 诊断！

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1055/a-2214-0397

Dominik Dickmann, Evangelos Karasimos

引用次数: 0

[A Different Take on Regional Anaesthesia]. [对区域麻醉的不同看法]。

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1055/a-2255-9368

Kai Zacharowski

引用次数: 0

[Common and New Regional Anaesthesia Techniques Under Review - From Head to Abdomen]. [常见和新的区域麻醉技术回顾 - 从头部到腹部]。

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1055/a-2065-7624

Thorsten Steinfeldt, Andreas Marx, Mark Dauster

引用次数: 0

[Relevance of the Allen Test before Catheterization of the Radial Artery]. [桡动脉导管术前艾伦测试的相关性]。

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1055/a-2265-8870

Lena Reese, Thomas Wurmb, Patrick Meybohm, Maximilian Kippnich

引用次数: 0

[Old and New Regional Anesthesia Procedures Under Review - Abdomen to Toe]. [新旧区域麻醉程序回顾 - 从腹部到脚趾]。

IF 0.4 4区医学

Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie Pub Date : 2024-03-01 Epub Date: 2024-03-21 DOI: 10.1055/a-2065-7660

Paul Kessler

引用次数: 0